Tag: science

Changing the Tune

Credit: Mika Baumeister
Authorities should create independent bodies to evaluate the science behind vapor—and base their policies upon the most credible evidence.
By George Gay
June 19, the Australian federal government announced a ban, from July 1, on the import of nicotine for vaping. The ban reportedly amounted to a de facto prohibition on vaping with nicotine because, while it provided for an exemption for imports made on the basis of a doctor’s prescription, the Australian Tobacco Harm Reduction Association (ATHRA) said that using such an exemption would have been complex, time-consuming and ultimately unworkable.
But temporary relief was granted when, on June 26, the government announced that it was suspending the implemen-tation of the ban while it conducted a review and consultation around the classification of nicotine. At the same time, how-ever, it said that a new version of the ban with a “streamlined” [but at the time unspecified] method for people to obtain prescriptions would be brought in from the start of next year.
There might be a good reason why the government is going to conduct this review when it has already decided to reintroduce a modified ban within six months, but it wasn’t immediately obvious to me what that reason might be. Having said that, perhaps there is no good reason. The government seems to have form in putting the cart before the horse.
According to ATHRA, the June 19 announcement of a ban was made before the publication of a report that was based on a scientific inquiry into vaping commissioned, at a cost of aud750,000 ($529,403), by the health minister last year.
I was reminded by all this of the nonsense song: “You put your left arm in / You take your left arm out / You do the hokey cokey / And you shake it all about.” I mean, even if you assume that vaping policy decisions in Australia are made on the basis of “two-up” and therefore might not always make a whole load of sense, that doesn’t explain the change that took place. Unless, that is, Australia is only partway through a best-of-three-throws series. In which case, before I get to the end of this piece, the policy might have changed again.
Despite, like the rest of us, being fully paid-up members of the club of sentient animals, Australian smokers and vapers may be allowed to import nicotine for vaping only if they have a prescription from their doctors, a certificate from their spiritual advisers and a letter signed by their mums. For goodness’ sake, these are adults who are allowed to buy and consume any amounts of cigarettes and alcohol, which are surely the two most toxic consumer products on the market.
I don’t want to trivialize what is a deathly important debate on vaping, but I find it difficult to take seriously such a rapid change of direction, even given that a week is a long time in politics. Of course, an argument can be made that the government acted responsibly in reacting to the opposition that quickly arose in respect of its June 19 nicotine ban—that it listened; that it had an open mind.
But it must be of concern that the government apparently didn’t listen before it made its announcement. And there has to be concern that the government might have suffered the same fate as many of those who attempt to maintain a completely open mind—that is, its brain fell out.
In fairness to the government, however, you have to say that the mess it got itself into was simply built on some fairly strong foundations already established by federal and state governments. For instance, as I understand things, even before the new ban was announced, nicotine for vaping was classified in Australia as a poison, and its import was illegal unless approved by the Therapeutic Goods Administration. Though, depending on the laws of individual states, nicotine could be bought over the internet provided it was for personal use. “You put your right arm in,” etc., etc .…
There are many arguments to be made against a ban on the import of nicotine for vaping, most of which will be familiar to the people who read this magazine, and those arguments are being well made in Australia by individuals, organizations such as ATHRA and politicians, even some within the ranks of the ruling coalition.
But one of the major problems for those opposing the ban is that it is irrational and, as has often been stated in the past, it is pretty well impossible to reason somebody out of a position that they didn’t reason themselves into.
And there could be significant negative consequences if the government persists with its policy of banning nicotine for vaping. Despite the best efforts of the World Health Organization (WHO) to ensure that smokers continue to smoke rather than switch to vaping, the smokers of Australia, who, unlike the WHO, don’t exist in a bubble that protects them from unauthorized ideas, know that vaping might be their best route to harm reduction. And some of them will continue, despite the ban, to try to remain on that harm reduction route by obtaining nicotine through whatever means possible.
This will inevitably create risks because some of that nico-tine will no doubt be produced in unlicensed premises and all of it will be mixed with other e-liquid ingredients by users with no training in such enterprises. Goodness me, to take another example, surely no government would encourage its untrained citizens to start producing their own alcohol?
And it seems obvious that the Australian government recognizes the risk of homebrewing e-liquids because, as part of its original ban, it set the penalty for infringements at aud220,000. The severity of the penalties set for laws reflect a number of things and, it seems to me, in some cases, one of those is the likelihood that people will break the law because it is unreasonable. And nothing could be more unreasonable than introducing a law that makes it more difficult for an individual to try to improve his or her own health.
URGENCY TO ACT
But there are many people better qualified than I am to make the case against the ban and who will be using the time to the end of this year to do so. I am interested in a more general question that arises out of the shambles that was the ban and its suspension—a question that pops up in other countries, that has global repercussions but that is less often addressed.
Why haven’t countries around the world and even the inter-national community arrived at a working consensus on vaping that leads us down a rational, clearly defined pathway with direction that can be adjusted as new information is received about the best way ahead?
Why do we persist with performing the vaping “Hokey Cokey”? After all, you would imagine, I think, that this issue would be viewed by authorities around the world as a matter of the greatest urgency.
We are told by the WHO that tobacco consumption, largely in the form of cigarette smoking, comprises one of the biggest public health threats the world has ever faced, killing more than 8 million people a year worldwide. At the same time, it is indisputable that some cigarette smokers have used vaping to purge themselves of their tobacco smoking habit.
And, according to a timeline published by the Consumer Advocates for Smoke-Free Alternatives Association (CASAA), the idea of electronic cigarettes has been around for about 90 years, and the first commercial unit was pro-duced 17 years ago.
In other words, there is clearly a need for urgency here, and there has been time to act. But as can be seen from the Australian experience—and Australia is by no means alone in this—17 years on, many countries are still at the most basic of consultation stages; or, to put it in the Australian vernacular, we’re still running around like headless chooks when it comes to vaping.
FEAR OF THE NEW
Why is this the case? I don’t know the answer to that question, but there are a number of possibilities that occur, some, unfortunately, that tend toward the sorts of conspiracy theories that tell you Covid-19 is spread by 5G and that you would be better off forswearing a Covid-19 vaccine, should one be developed, and protecting yourself instead by sitting in a darkened room with a mixture of cow dung and honey on your head while listening to recordings of the narwhal daring us to be free.
Credit: Obi Onyeador
But much as I like a truly bonkers conspiracy theory, I think I need to keep this piece on a reasonably even keel and, the more I think about it, the more I tend to the view that the major problem the world has in embracing vaping is that it is different to what we are familiar with—good old smoking. In The Book of Nothing, John D. Burrow quotes Francis Cornford as saying, “Every public action, which is not customary, either is wrong or, if it is right, is a dangerous precedent. It follows that nothing should ever be done for the first time.”
Perhaps because it is not much into irony, the WHO seems to have taken seriously this reasoning in its approach to vaping. While acknowledging that much has been written about the potential of electronic cigarettes to help tobacco users quit, it says the evidence is inconclusive and goes on to advise against e-cigarette use.
OBJECTIVE EXAMINATION
Given the enormous differences between the constituents of tobacco smoke and those of e-cigarette vapor, and given the evidence that points to the ability of vaping to substitute for smoking for a significant number of smokers, the WHO’s position seems to take the precautionary principle to absurd heights. And one of the problems here is that the WHO exerts enormous influence over the health policies of many countries.
But there is no need for governments of the world to slavishly follow the WHO line. There is available to governments a huge amount of information on vaping from which they can make their own judgements and decisions. At the same time, however, there is a problem because while some of the information available is reasonable, some of it is questionable and some of it is unreasonable.
And since this information is being made available in a constant stream, there is probably little wonder that governments announce policies that within a week have to be suspended. To my way of thinking, what is needed, therefore, is for countries to establish taxpayer-funded bodies that are isolated from lobbyists and that are staffed with scientists who can examine objectively any scientific papers produced in respect of vaping and vapor devices.
Such bodies would examine all such papers and exclude any, no matter what side of the debate they supported, that did not meet the required standards of methodologies and results interpretation.
These bodies could then make precis for politicians of the papers that were found to advance the vaping debate. In this way, governments would be able to make decisions on the basis of facts, they would not be continually pulled this way and that by the latest bungled interpreta-tions of the results of biased research, and they would have no excuse for inserting their own biases.
Of course, some would complain that this would be an expensive exercise, but given what we are told are the extremely negative health, economic and social con-sequences of the continuing smoking epidemic/pandemic, such expenditure would surely be repaid many times over.
Others might complain that the U.S., for instance, already has the Food and Drug Administration (FDA) to oversee research in this way, and there is some truth in this. But the FDA also makes and enforces regulations, it interacts with those carrying out research and its decisions are subject to court challenges.
Credit: Vaporesso
The bodies I envisage would act sim-ply as filters that let through to regula-tory bodies only the research results that have passed close scientific scrutiny. They would perform peer reviews as part of a process that was properly funded and fit for purpose. They would not make policy recommendations and, importantly, their decisions would not be open to challenge, though the workings of these bodies would be subject to scrutiny by a suitable organization.
Surely it would be worthwhile putting in place such bodies so that, if vaping has the potential that many people believe it has to prevent a significant number of smoking-related deaths, that potential can be fully realized. And, of course, if it were found that that potential did not exist or could not be realized, it would allow us to move on. Such a process has got to be better than doing the “Hokey Cokey” on a loop. V
August 17, 2020
U.S. FDA Approves CBD Drug for New Seizure Treatment

Credit: GW Pharma
The US Food and Drug Administration (FDA) has approved the cannabidiol (CBD) drug Epidiolex oral solution for the treatment of seizures associated with tuberous sclerosis complex (TSC) in patients one year of age and older, according to press release from GW Pharma.
TSC is a rare genetic disease that causes non-cancerous tumors to grow in the brain and other parts of the body like the eyes, heart, kidneys, lungs, and skin. TSC affects about 1 in 6,000 people, according to the release.
Epidiolex was previously approved for the treatment of seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS). This is the only FDA-approved drug that contains a purified drug substance derived from cannabis. It is also the second FDA approval of a drug for the treatment of seizures associated with TSC.
Epidiolex’s effectiveness for TSC-associated seizures was established in a randomized, double-blind, placebo-controlled trial where 148 patients out of 224 received Epidiolex. Patients treated with Epidiolex had a significantly greater reduction in the frequency of seizures during the 16-week treatment period than patients who received placebo.
The most common side effects in Epidiolex-treated patients were: diarrhea, elevated liver enzymes, decreased appetite, sleepiness, fever, and vomiting. The FDA had granted Priority Review designation for this application.
August 5, 2020
Study Finds CBD Industry Will Suffer Major Losses in 2020

Credit: Terre di Cannabis
The economic turmoil cause by the global pandemic will force thousands of cannabidiol (CBD) businesses to close. According to cannabis research firm Brightfield Group, while many industry players will leave, the CBD market will remain flooded with some 1,500 brands jostling for market share, .
The top 20 over-the-counter CBD companies accounted for just 17 percent of the overall CBD market in early 2020, with some 3,000 other competitors crowding 77 percent of the market, the firm estimated in a report released last week.
The largest CBD producer, London’s GW Pharmaceuticals, makes prescription CBD medicines and accounted for the final 6 percent of U.S. CBD sales, according to Brightfield’s count.
The flooded market is a result of entrepreneurial enthusiasm for a booming trend with few established brands, according to an article in hempindustrydaily.com. Throughout 2019, the CBD market saw so many new CBD market participants that those earning less than $1 million in annual revenues occupy over 97 percent of the market, Brightfield concluded.
But the crowd of CBD companies is going to thin substantially in 2020, with COVID-19 driving a likely “extinction event” for half or more of those companies, said Bethany Gomez, managing director of the Florida-based research firm, according to the story.
“A lot of companies that were kind of dabbling in the category have found it to be unsustainable for them,” Gomez said. “A lot of brands that had tried this out, it’s not something that they’ve been able to turn a profit on.”
Not all new CBD startups are discouraged by the flood of competitors. For Jennifer Culpepper, who helped launch CBD skincare line i+i Botanicals in mid-2019, the market was already crowded.
“Our biggest challenge is to find our positioning and where we differentiate ourselves from other brands,” said Culpepper, who is based in Maryland. “How do you differentiate your CBD in a tincture?” she said. “We think of ourselves as a skin-care or self-care company that uses CBD as ingredient. That’s what sets us apart.”
The strategy is proven by Brightfield’s research, which notes that traditional CBD products – tinctures and gummies – are slipping in terms of market share. “The market is no longer entirely dominated by sufferers of extreme pain or epilepsy who must go to great lengths to attain product, nor primarily by cannabis consumers,” Brightfield reported.
Brightfield’s analysis did show some positive signs for CBD makers – notably that sales overall haven’t substantially slipped during the pandemic. The sector’s resilience is especially encouraging given national uncertainty about the economy and the level of unemployment enhancements the federal government stopped paying last week, Gomez said.
August 4, 2020
A Welcome Message

Credit: Troy T
Buried under the Covid-19 headlines, a recent Public Health England report reiterates the value of vaping for smoking cessation.
By George Gay
Amid the unfolding tragedy and chaos on March 11, when the World Health Organization (WHO) declared that the spread of Covid-19, the disease caused by the SARS-CoV-2 coronavirus, had reached pandemic proportions, it was easy to lose sight of the fact that the world was in the grip of a number of pandemics, one of which, according to the WHO, is the “smoking [tobacco] pandemic.”
I have never understood how smoking can sensibly fit into the definition of a pandemic, but then it seemed to me that Covid-19 had been of pandemic proportions for a while before it was declared to be so. What do I know? I’m just some mug in lockdown whose rights have been taken away by the people who should have avoided the necessity to do this by having been part of a global initiative to prevent the emergence of such viruses or at least to deal with their effects far more efficiently than has been the case. Still, you know me—I don’t like to complain.
Is there some reason why I have drawn attention to the existence of the two pandemics, I sense you asking? Well, since you raise the issue, the two are loosely connected, at least in England. About a week before the WHO bestowed pandemic status on Covid-19, Public Health England (PHE) had issued its latest vaping report in March (“Vaping in England: An Evidence Update Including Mental Health and Pregnancy”), and vaping, as I think any fair-minded person would admit, has the power, in the parlance of our times, to help flatten the curve of smoking and no doubt, along with other initiatives, to eventually eliminate this pandemic.
PHE, which is an executive agency sponsored by the Department of Health and Social Care, has long said that vaping regulated nicotine products poses a small fraction of the risks of smoking and that vaping such products, in conjunction with other interventions, will greatly increase the chances of tobacco smokers stopping smoking. And these comments were confirmed in its latest report.
So everything is hunky-dory? Smokers can gradually move to vaping and other activities associated with next-generation nicotine products once those products meet their expectations, and at least one pandemic will have been dealt with? Of course, as anybody reading this magazine will be aware, things are not that simple. Ever since vaping came onto the scene, there have been no end of people willing to condemn it as smoking by another name, and their voices have been amplified in much of the media, which has reveled in running questionable headings to scare the pants off smokers and would-be vapers without the necessity of producing any evidence as to why they should be scared of vaping. “Is vaping riskier than smoking?” is the type of heading often used. Of course, the short answer to the question is “no,” but if you’re paid by the word …
Given these circumstances, the sane voice of organizations such as PHE are vital, and it is a pity that its latest report probably received much less coverage than it might have done if the media had not been preoccupied with the Covid-19 pandemic rather than, as usual, the smoking pandemic. After all, from what we are told, the former is not going to cause anything approaching the death toll attributed to the latter.
Certainly, British American Tobacco (BAT) welcomed the report. David O’Reilly, the company’s director of scientific research, was quoted on its website as saying, in part, that it was encouraging to see PHE continuing to highlight that “regulated vapor products are much less harmful than cigarettes and that vaping continues to help those U.K. smokers seeking an alternative to make the switch.”
So let’s try to give a little airing to the PHE’s March 4 report, the summary of which, to my mind, is admirable for combining science with common sense in a clearly written document that is easily digestible by ordinary smokers and vapers and by people, such as me, who are not scientists. The document confirms in part that the conclusions of PHE’s previous reports are still “important messages for preventing harm” and that these conclusions, broadly summarized, are as follows:
• Vaping regulated nicotine products has a small fraction of the risks of smoking, but this does not mean it is safe.
• Smokers should be encouraged to try regulated nicotine vapor products along with smoking cessation medications and behavioral support. This will greatly increase their chances of successfully stopping smoking.
• People who have never smoked should be encouraged not to smoke and not to vape.
• Vapers should be encouraged to use regulated nicotine products only and stop smoking completely.
To my mind, it is one of the smallest figures within the PHE report that needs to be given the most airing—that needs to be used as a strap line on every vaping story. “Vaping remains most common among smokers and former smokers, with less than 1 percent of people who have never smoked currently vaping,” the report says. Less than 1 percent. That figure completely undermines a common claim made by those implacably opposed to vaping: that vaping will draw a wave of nonsmokers to nicotine addiction. In fact, taken together with other figures in the report, it demonstrates that vaping is a means to improving the health outcomes of individuals and the population at large. As PHE says, most adults use vapor products to help them quit smoking.
Growing misperceptions
It has to be of concern, therefore, that those opposed to vaping have been successful in getting their messages across. “Perceptions of harm from vaping among smokers are increasingly [my emphasis] out of line with the evidence,” PHE reports. “The proportion who thought vaping was less harmful than [smoking] cigarettes declined from 45 percent in 2014 to 34 percent in 2019. These misperceptions are particularly common among smokers who do not vape.”
O’Reilly was quoted on the BAT website as saying that the growing misperceptions regarding the relative risks of vaping and smoking were deeply concerning and likely to be contributing to a huge missed opportunity from a public health point of view. “It’s key that smokers have access to accurate facts regarding these important products in order to make an informed choice,” he said. “As one of the world’s largest vaping companies, which puts science, product safety and testing at the heart of everything we do, we are committed to working with public health bodies, harnessing our global resources and expertise, to help educate smokers regarding the potential benefits of vaping.”
Such misperceptions, which are not the results of accidents, have their consequences because “stop smoking services in England suggest that when a vaping product is used in a quit attempt, either alone or with licensed medication, success rates are comparable to, if not higher than, licensed medication alone,” according to PHE.
Such quit attempts have been largely stalled for the past five years, however. PHE reports that current vaping prevalence (any current use) among adults in England has remained stable since 2014, and in 2019, it was between 5 percent and 7 percent. At the same time, current vaping prevalence among smokers varied between 14 percent and 20 percent across the surveys studied, again showing little change since 2014. But current vaping prevalence among former smokers has continued to rise and was 12 percent to 13 percent in 2019. Vaping prevalence is said to be highest among people in more disadvantaged socioeconomic groups, reflecting their higher levels of smoking.
Meanwhile, the proportion of current smokers who have not even tried vapor products apparently remained at 37 percent between 2018 and 2019, suggesting that those “Is vaping riskier than smoking?” headings have been doing their job in creating an atmosphere of unfounded fear around vapor products.
Credit: Ciprian Tudor
No epidemic
Some of the most surprising aspects of the report have to do with vaping among young people, which seems to be at a low level, contrasting starkly with what we are often led to believe in England and what we are told is an “epidemic” of vaping among young people in the U.S. It is worth noting here that PHE points out in its report summary that comparisons across countries are hampered by inconsistent questions and survey methods, though it also says that “[o]ne survey that compared vaping among 16-[year-olds] to 19-year-olds from 2017 to 2018 using consistent methods found lower levels of vaping in England compared to [those in] Canada and the U.S.”
PHE reported that current vaping prevalence (weekly or less than weekly) among young people in England has remained reasonably steady with the best recent estimates putting it at 6 percent of 11-year-olds to 15-year-olds in 2018 and 5 percent of 11-year-olds to 18-year-olds in 2019. No surveys were said to have reported much increase in vaping prevalence.
As you would expect, the older a youngster is, the more likely she is to vape; so current use among 11-year-olds was estimated at less than 1 percent in 2018 compared with 11 percent of 15-year-olds.
Again, as you could expect, current vaping is mainly concentrated in young people who have experience smoking. In fact, less than 1 percent of young people who have never smoked are current vapers, and PHE noted that current smoking prevalence (weekly or less than weekly) among 11-year-olds to 15-year-olds halved between 2009 (11 percent) and 2018 (5 percent), though it had remained relatively steady since 2014.
PHE reported that young people’s perceptions of the relative harms of vaping compared with smoking are increasingly out of line with the evidence, reflecting, but not as starkly, the situation among adults. The proportion of 11-year-olds to 18-year-olds who thought that vaping was less harmful than smoking declined from 68 percent in 2014 to 52 percent in 2019. Just over a third of 11-year-olds to 15-year-olds thought it was OK to try vaping, and just under a quarter thought it was OK to vape once a week. Most young people who have tried vaping did so out of curiosity.
Almost 60 percent of 11-year-olds to 15-year-olds who vaped regularly (more than once a week) reported being given vapor products, mostly by friends. But many also reported buying vapor products from other people, shops and the internet, and PHE believes that “enforcement of age of sale regulations needs to be improved.” Tank models remain the most popular type of vapor device used by young people in England.
The March-issued report, which presents updates on the prevalence of vaping among young people and adults and reviews literature on vaping among people with mental health conditions and pregnant women, is the sixth in a series of independent reports commissioned by PHE to summarize evidence on e-cigarettes to inform policies and regulations. PHE says that a “comprehensive e-cigarette safety review will be the focus of a future report.”
In setting out the aims of the report, PHE said that despite reductions in smoking prevalence, smoking remained the biggest single cause of preventable death and disease and a leading cause of health inequalities. “So, alternative nicotine-delivery devices that are less harmful could play a crucial role in reducing this health burden,” it said.
June 22, 2020
Study: Pod-Style Products Can be More Addictive

Pod-style vapor products have an efficient delivery of nicotine. A new study by Harvard T.H. Chan School of Public Health finds that the nicotine salts used by the devices may foster greater dependence than other types of e-cigarettes.
According to the study, the design of pod-based e-cigarettes ensures the delivery of high doses of nicotine in a low pH form, which is less harsh compared to the higher pH nicotine found in most other e-cigarette brands, thus encouraging deeper inhalation.
This is the first paper to synthesize research findings on Juul and similar pod-based devices, said first author Stella Lee, formerly a National Cancer Institute Cancer Prevention postdoctoral fellow in the Department of Social and Behavioral Sciences and currently an assistant professor at Konkuk University in South Korea, according to the Harvard Gazette.
“We found that pod-based e-cigarettes have a higher potential to get youth and young adults addicted than other devices,” she said. “To prevent this from happening, we need stronger health communication messages that alert people to these findings.”
The study will be published online June 1 in JAMA Pediatrics.
June 2, 2020
Study: Length of Ring Finger a Factor in Lower Covid-19 Risk

Men with longer ring fingers face a lower risk of dying from Covid-19 and are more likely to suffer mild symptoms, researchers claim. Academics found coronavirus death rates in countries where men have shorter ring fingers were up to a third higher.
Ring finger length is determined by how much testosterone a foetus is exposed to when growing in the womb, the experts said. The more testosterone a male is exposed to in the womb, the longer their ring finger will be, it is believed, according to a story on The Daily Mail.com.
Testosterone is thought to be protective against severe Covid-19 by increasing the number of ACE-2 receptors in the body. Scientists believe the coronavirus, officially called SARS-CoV-2, enters the body and causes infection through these receptors.
But studies also suggest that high levels of ACE-2 receptors can protect against lung damage, which the coronavirus can cause. The new study, carried out by Swansea University, found men with low testosterone levels are twice as likely to die of Covid-19 than men with higher levels.
Mounting evidence has shown men are more likely to die from the coronavirus than women – but scientists have been unable to determine exactly why this is. In England and Wales, the Covid-19 death rate for men is 97.5 per 100,000 people compared to 46.5 for females, according to the Office for National Statistics.
Scientists believe men are less likely to wash their hands, may not seek medical help, and have more underlying health conditions that make them more vulnerable. But testosterone could be one of the key reasons why so many men are dying from coronavirus, doctors believe.
Swansea University experts added to the theory that men who have low testosterone levels are at more at risk of Covid-19 than other men. They looked at data of 200,000 people in 41 countries where the researchers had already measured the finger lengths of volunteers.
Some researchers believe finger lengths reflect a foetus’s exposure to testosterone and other hormones that guide development in the womb. The index finger and the ring finger was measured to the closest millimetre. The first measurement is divided by the second measurement to get the 2D:4D ratio.
The smaller the digit ratio, the longer the ring finger is. The country with the smallest average male right hand digit ratio was Malaysia, with 0.976. The higher the digit ratio, the shorter the ring finger is. Bulgaria has the highest male right hand digit ratio, with 0.99.
Researchers found that in countries where the male digit ratio was smaller, including Malaysia, Russia and Mexico, the case fatality rate of Covid-19 was lower. And in countries where the male digit ratio was higher, including the UK, Bulgaria and Spain, the case fatality rate was higher.
May 28, 2020
Vapor Group Asks For WHO Misinformation to be Rejected

A vaping advocacy group in New Zealand has asked the Ministry of Health to reject information peddled by the World Health Organization (WHO) which inaccurately and negatively reflects on smoke-free nicotine products.
The Aotearoa Vapers Community Advocacy (AVCA) has written to Associate Health Minister, Jenny Salesa, calling for New Zealand’s position to support current global scientific evidence instead, according to an article on scoop.co.nz.
New Zealand’s Ministry of Health is [was] preparing to present at the Ninth Session of the Conference of the Parties (COP9) to the World Health Organisation’s Framework Convention on Tobacco Control (WHO-FCTC) at The Hague, in the Netherlands, this November. However, the conference has now been cancelled due to Covid-19 concerns.
Director of AVCA, Nancy Loucas, says consumers have been effectively excluded by WHO-FCTC so it is entirely up to the Ministry of Health to represent the interests of the New Zealand public.
“We need you to represent our interests based on pragmatic decisions based on current scientific evidence and verified information on the benefits of the reduced risk products.
“There are numerous scientific studies and statistical evidence reports that prove the harms of these products are no more than five percent of the harms of combustible tobacco. Nicotine is no more addictive than caffeine, and hundreds of thousands of smokers worldwide have been successful switching off combustible tobacco using ENDS (electronic nicotine delivery systems), HTPs (heated tobacco products) as well as snus,” AVCA wrote.
Loucas says despite such evidence, the WHO-FCTC continues to issue information, reports and guidance that contains several inaccuracies regarding e-cigarettes. It insists that ENDS and smokeless alternatives do not help smokers quit smoking; are more harmful than combustible tobacco; and that nicotine is equivalent to heroin in terms of addictiveness.
She believes the WHO’s position is being influenced by vested interests that provide funds to the organisation. The ‘WHO Global Report on the Tobacco Epidemic 2019’ and the ‘WHO Q&A detail on E-cigarettes’ were written with and funded by individuals who have a vested financial interest in pharmaceutical nicotine replacement therapies in development, she says.
“This vested interest has coloured the information in order to serve the political and financial interests of Bloomberg Philanthropies and the Gates Foundation who provide nearly half of all the funding for the WHO-FCTC.
“The WHO is lying to you to protect their own financial interests and keep their private donors happy. They are not objective. They are not focused on their own mandate under FCTC to promote the health of the people and their right to have information to make informed choices regarding their health,” AVCA wrote in its letter to Minister Salesa.
AVCA continues to call for New Zealand’s confirmed position on smoke-free nicotine products to be publicly released ahead of the Ministry of Health’s presentation at the WHO’s Framework Convention on Tobacco Control at The Hague later this year.
May 26, 2020
Expert Advice
In their response to the recent vaping scare, health authorities may have done the public a disservice.
By George Gay
After listening to a few presentations given at the 2019 Global Tobacco & Nicotine Forum (GTNF), I started to wonder anew about the word “expert,” though I should make it plain that I am not questioning the expertise of the presenters.
The presentations suggested, among other things, that experts in the U.S. were reacting irrationally to health issues recently raised in respect of the use of vapor devices; that some vaping policies developed by U.S. experts were, to say the least, unhelpful; that people were broadcasting on U.S. television information about vaping that appeared to be expert but that was simply wrong; and that any number of governments outside the U.S., presumably advised by experts, were making irrational decisions in respect of vaping.
If it is true that experts are causing so many mismoves, what, you might ask, is an “expert”? Good question. Just after the U.K.—or parts thereof—voted in 2016 to leave the EU, a prominent politician and leave campaigner caused some disquiet when, in refusing to name any economists who backed the country’s exit from the EU, he was reliably quoted as saying that “people in this country have had enough of experts.”
He was clearly talking about expert economists, but his statement was condemned widely, including by one popular scientist whose television programs reach a wide audience. The gist of the responses was that if people shut their ears to the opinions of experts, chaos and anarchy would descend upon the world.
This has a ring of truth about it, but I suppose some might retort that chaos, in the form of environmental breakdown, is being given a clear run even with any number of experts in place. But again, while this retort would have a ring of truth about it, it would sidestep the uncomfortable fact that environmental experts are not in control of the environment. They must compete with experts at plundering our natural resources in the name of making money for the ear of politicians, who, while democracy still stands, have the final say. Like it or not, politicians are the experts of last resort.
One way of getting around the issue of experts failing in their chosen fields is to assume that there is no such thing as an expert. All you must do is extrapolate to all fields of endeavor what William Goldman said about the motion picture business: “Nobody knows anything.” And while that might sound a mite dismissive, it is much less so when you consider that he went on to qualify that remark with, “Every time out it’s a guess and, if you’re lucky, an educated one.”
That raises another issue. What part of being an expert is played by education and intelligence, two concepts that I have to admit I would struggle to define and the latter of which I would have no idea how to measure? Still, such lack of knowledge does not stop me from wondering whether an expert necessarily must be well educated and intelligent. Indeed, are education and intelligence inextricably linked? I would suggest not. Clearly, many people are intelligent without being educated while many well-educated people are not what I would judge to be intelligent because they lack attributes such as common sense, creativity and natural wit.
Nowhere is it better demonstrated that a lack of education and intelligence need not be a bar to be an expert than in the U.K.’s Houses of Parliament. Votes form the only qualification necessary for being a representative of the people in the House of Commons, given that one meets certain criteria to do with such things as age, citizenship and the ability to stump up a nonrefundable deposit, while membership of the House of Lords is down to a complex form of Buggins’ turn that doesn’t bear too much scrutiny much of the time.
That’s worth thinking about. The people who are voting on issues that will affect everybody in the land and some of those overseas, and who might plunge us into war, need not be educated or intelligent, and they need not be what many people would consider to be an expert. Indeed, a person with little education and the wit of a paving slab could become a Member of Parliament and be elevated to a high office of state, depending on just how far she is willing to go in towing the party line or on what Homer Stokes would describe as the state of cronyism, nepotism and rascalism within the system.
But, of course, you don’t have to be thick as a brick to be a politician, and many are highly educated and intelligent. Recently in the U.K., a prominent politician implied that his superior intelligence or common sense would have allowed him to escape from a tragic event in which many people were killed. The politician is, without question, well-educated and intelligent, but, judged only on this comment, you would think him otherwise.
Apart from the fact that his remark was crass, hurtful and politically dumb, he had failed to discern that what divided him from the people who died was not intelligence but the availability of information. He was viewing the tragedy from the safety of his armchair and with benefit of hindsight. Those who died were caught up in fast-moving events and were acting in line with official advice—advice provided by experts.
But I digress. To me, the post-referendum brouhaha about experts in the U.K. came down to the fact that people see things differently. A specialist’s view of an expert is different to that of the person in the street. To the specialist, an expert is somebody learned in their field, though not necessarily somebody the specialist would agree with, while to the person in the street, an expert is somebody who gets things right, and those two attributes don’t always go hand in hand.
Within the field of science, however, these two definitions of what constitutes an expert should not cause so much conflict as in some other fields because, in theory, science is a dynamic process in which theories are raised, confirmed or refuted and then, in either case, used to develop new ideas. This does not necessarily work in the same way in other fields, such as economics, as our post-2008 world amply demonstrates. In the field of economics, I would suggest, expert opinion is like art and philosophy—it is basically whatever you can get away with.
There is a further complication, however, and that is between what I would roughly describe as “big science” and “small science.” We can all watch a television program about Heisenberg’s uncertainty principle and nod off to sleep happy in the knowledge that if we don’t catch the end of the program, we are not going to be put at any direct disadvantage, no matter how important the principle is to quantum theory.
Nod off, however, during a program on the damage done by the consumption of a certain foodstuff, and you could be shortening your life by a year or whatever. Or perhaps not, depending on whether the scientific experts on the program have got it right—indeed, in the terms of the lay person, whether those scientists are experts.
This is important, in my view, because the person in the street is being asked increasingly often to make judgments when “experts” disagree or rather when there might be broad agreement among experts but there are also loud, dissenting views also from experts—economists in the case of Brexit and globalization, say, public health professionals in the case of vaping and vaccinations, and scientists in the case of climate change and quantum theory.
So how is it possible for nonspecialists to make those calls? Well, there are strategies we can all employ depending on how much time we have. Common sense often helps but is not 100 percent reliable. We can ask ourselves why we think the expert is saying what she is saying—especially, who is funding her research and does she or a close relative or friend have a vested interest in what she is saying?
We can investigate her previous research and intercessions, we can try to chase down her credentials, keeping in mind that her qualifications might have been bought online, and we can investigate what her peers say about her, bearing in mind that we really ought firstly to check out just where they’re coming from. And if we’re retired and have some long winter evenings to fill, we can even try our hand at reading, without nodding off, the scientific literature, and we can revisit all of the information we have gathered to see how much of it has come from sources where lying is seen as part of the great rough and tumble of life.
But all of this gets thrown out of the window when the person in the street has little time to make what appears to be a life-affecting decision quickly and the advice being given out by normally reliable institutions conflicts with some other expert advice and common sense. This is what happened, in fact, when, earlier this year, there was an outbreak in the U.S. of acute pulmonary illness among a relatively small number of vapor device users.
The initial advice from the U.S. Centers for Disease Control and Prevention (CDC) was for people to stop using vapor devices with THC oil or nicotine liquids. Common sense indicated, however, that whereas it seemed plausible that the inhalation of THC oil, especially black market THC oil, which was a relatively recent activity, could be the cause of the outbreak, it was implausible that nicotine liquids, which had been consumed in this way around the world for about 10 years, were the cause of the problems. This seemed like a case of science, in the form of scientific experts at the CDC, getting it wrong.
At the time of writing, the CDC seems to have come around to a position closer to that dictated by common sense—an approach, by the way, that had the backing of some healthcare professionals. The problem, however, is that much damage has been done already. The fear raised in the minds of the public slowed the conversion of smokers to vapers and caused some converts to relapse.
It is worrying that this development seems to support the idea that “good” vaping science is always going to be playing catch-up with “bad” vaping science and that sometimes it is never going to catch up. What I mean by this is that the shock-horror headline on page one might be overturned the next month but only with a piece at the bottom of page 32. One of the presentations at the GTNF, which was held in Washington, D.C., in September, included a number of clips from a television program. One of these clips implied that vaping with nicotine liquids could reduce the IQs of young people by 10–15 points from what they might have otherwise been. It was then pointed out that measuring such IQ deficits was difficult, something that could probably be accurately interpreted as being impossible and therefore never having been done.
But as the GTNF presenter pointed out, even though there were only a few seconds between the statements being made, the damage had surely been done. Most viewers, especially those with children still at school, were going to remember the 10–15 point IQ deficit because it was aimed at the heart and because it would later be in 72-point type on page one while few were going to remember the retraction, which was aimed at the head and was bound for an 18-point presentation on page 32.
There is a further problem here. Once those viewers who watched the program and who absorbed the 10–15 point statement passed this information on to their friends at the school gate, they were probably well on their way to becoming experts. Their friends would ensure this in quoting them while passing on the information to others.
Perhaps we are all bound to become experts for 15 minutes. What a frightening thought.

George Gay
December 23, 2019